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Reduced levels of circulating progenitor cells in juvenile idiopathic arthritis are counteracted by anti TNF-α therapy.

Martini G, Biscaro F, Boscaro E, Calabrese F, Lunardi F, Facco M, Agostini C, Zulian F, Fadini GP - BMC Musculoskelet Disord (2015)

Bottom Line: Children with active JIA showed a significant reduction of relative and absolute counts of circulating progenitor cells and EPCs compared to age-matched healthy controls.A strong inverse correlation was found between serum TNF-α and EPC levels.Children with JIA have reduced levels of the vasculoprotective and proangiogenic EPCs.

View Article: PubMed Central - PubMed

Affiliation: Paediatric Rheumatology Unit, Department of Paediatrics, 35128, Padova, Italy. martini@pediatria.unipd.it.

ABSTRACT

Background: Endothelial progenitor cells (EPC) promote angiogenesis and vascular repair. Though reduced EPC levels have been shown in rheumatoid arthritis, no study has so far evaluated EPCs in children with juvenile idiopathic arthritis (JIA). We aimed to study circulating EPCs in children with JIA, their relation to disease activity, and effects of anti TNF-α treatment.

Methods: Circulating EPCs were quantified by flow cytometry based on CD34, CD133 and KDR expression in peripheral blood of 22 patients with oligoarticular JIA and 29 age-matched controls. EPCs were re-assessed in children with methotrexate-resistant oligo-extended JIA before and up to 12 month after initiation of anti-TNF-alpha therapy. Plasma concentrations of inflammatory and EPC-regulating factors were measured using a multiplex array. Confocal immunofluorescence was used to demonstrate EPCs in synovial tissues.

Results: Children with active JIA showed a significant reduction of relative and absolute counts of circulating progenitor cells and EPCs compared to age-matched healthy controls. CD34(+) cell levels were modestly and inversely correlated to disease activity. A strong inverse correlation was found between serum TNF-α and EPC levels. In 8 patients treated with anti TNF-α agents, the number of EPCs rose to values similar to healthy controls. CD34(+)KDR(+) EPCs were found in the synovial tissue of JIA children, but not in control.

Conclusions: Children with JIA have reduced levels of the vasculoprotective and proangiogenic EPCs. While EPCs may contribute to synovial tissue remodelling, EPC pauperization may indicate an excess cardiovascular risk if projected later in life.

No MeSH data available.


Related in: MedlinePlus

Correlation between CD34+ cells and disease activity. A significant inverse linear correlation was detected between total CD34+ cells and the physician’s visual analogue scale.
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Fig2: Correlation between CD34+ cells and disease activity. A significant inverse linear correlation was detected between total CD34+ cells and the physician’s visual analogue scale.

Mentions: Among all clinical characteristics, we only found a significant negative correlation between CD34+ cell levels and the physician’s visual analogue scale (Figure 2), though this was mainly attributable to 3 patients with low disease activity. There was no association between progenitor cells and the clinical subtype (persistent oligoarticular or extended oligoarticular), disease duration, and ongoing treatment regimens with NSAIDs and MTX.Figure 2


Reduced levels of circulating progenitor cells in juvenile idiopathic arthritis are counteracted by anti TNF-α therapy.

Martini G, Biscaro F, Boscaro E, Calabrese F, Lunardi F, Facco M, Agostini C, Zulian F, Fadini GP - BMC Musculoskelet Disord (2015)

Correlation between CD34+ cells and disease activity. A significant inverse linear correlation was detected between total CD34+ cells and the physician’s visual analogue scale.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4418050&req=5

Fig2: Correlation between CD34+ cells and disease activity. A significant inverse linear correlation was detected between total CD34+ cells and the physician’s visual analogue scale.
Mentions: Among all clinical characteristics, we only found a significant negative correlation between CD34+ cell levels and the physician’s visual analogue scale (Figure 2), though this was mainly attributable to 3 patients with low disease activity. There was no association between progenitor cells and the clinical subtype (persistent oligoarticular or extended oligoarticular), disease duration, and ongoing treatment regimens with NSAIDs and MTX.Figure 2

Bottom Line: Children with active JIA showed a significant reduction of relative and absolute counts of circulating progenitor cells and EPCs compared to age-matched healthy controls.A strong inverse correlation was found between serum TNF-α and EPC levels.Children with JIA have reduced levels of the vasculoprotective and proangiogenic EPCs.

View Article: PubMed Central - PubMed

Affiliation: Paediatric Rheumatology Unit, Department of Paediatrics, 35128, Padova, Italy. martini@pediatria.unipd.it.

ABSTRACT

Background: Endothelial progenitor cells (EPC) promote angiogenesis and vascular repair. Though reduced EPC levels have been shown in rheumatoid arthritis, no study has so far evaluated EPCs in children with juvenile idiopathic arthritis (JIA). We aimed to study circulating EPCs in children with JIA, their relation to disease activity, and effects of anti TNF-α treatment.

Methods: Circulating EPCs were quantified by flow cytometry based on CD34, CD133 and KDR expression in peripheral blood of 22 patients with oligoarticular JIA and 29 age-matched controls. EPCs were re-assessed in children with methotrexate-resistant oligo-extended JIA before and up to 12 month after initiation of anti-TNF-alpha therapy. Plasma concentrations of inflammatory and EPC-regulating factors were measured using a multiplex array. Confocal immunofluorescence was used to demonstrate EPCs in synovial tissues.

Results: Children with active JIA showed a significant reduction of relative and absolute counts of circulating progenitor cells and EPCs compared to age-matched healthy controls. CD34(+) cell levels were modestly and inversely correlated to disease activity. A strong inverse correlation was found between serum TNF-α and EPC levels. In 8 patients treated with anti TNF-α agents, the number of EPCs rose to values similar to healthy controls. CD34(+)KDR(+) EPCs were found in the synovial tissue of JIA children, but not in control.

Conclusions: Children with JIA have reduced levels of the vasculoprotective and proangiogenic EPCs. While EPCs may contribute to synovial tissue remodelling, EPC pauperization may indicate an excess cardiovascular risk if projected later in life.

No MeSH data available.


Related in: MedlinePlus